A Systematic Review of the Therapeutic Effects of Intact Canal Wall Mastoidectomy and Open Mastoidectomy for Cholesteatoma Otitis Media
10.3969/j.issn.1006-7299.2015.06.017
- VernacularTitle:完壁式与开放式乳突根治术治疗胆脂瘤中耳炎疗效的国内文献 Meta 分析
- Author:
Tingting WU
;
Cen ZHANG
;
Tao PENG
;
Kaiyu SUN
- Publication Type:Journal Article
- Keywords:
Intact canal wall mastoidectomy;
Open mastoidectomy;
Cholesteatoma otitis media;
Thera-peutic effect;
M eta-analysis
- From:
Journal of Audiology and Speech Pathology
2015;(6):637-642
- CountryChina
- Language:Chinese
-
Abstract:
Objective To carry out a meta-analysis on the published data to evaluate therapeutic effects of intact canal wall mastoidectomy and open mastoidectomy for cholesteatoma otitis media .Methods A comprehensive search was performed in VIP (1989-2015) ,WANFANG (1999-2015) ,CNKI (1994-2015) and CAJD databases to collect the randomized controlled trials (RCTs) on the intact canal wall mastoidectomy and open mastoidectomy treat cholesteatoma otitis media ,and to analyze the RCTs in meta -analysis method .Results 1 069 patients were analyzed in the 18 RCTs which met the inclusion criteria .Patients were followed up from 3 months to 7 years .The meta-analysis results suggested that ,compared with the open mastoidectomy group ,the patients had less operative time (test for overall effect :Z=15 .54 ,MD= -18 .36 ,95% CI(-24 .54 ,-12 .18) , P<0 .000 01) ,less dry ear time (test for overall effect :Z=8 .64 ,MD= -13 .90 ,95% CI(-17 .05 ,-10 .75) , P<0 .000 01) ,less complica‐tions (test for overall effect :Z=7 .63 ,OR=0 .19 ,95% CI(0 .12 ,0 .29) , P<0 .000 01) ,and more patients with decreased pure tone air conduction thresholds >10 dB (test for overall effect:Z=2 .83 ,OR=2 .47 ,95% CI(1 .32 , 4 .61) ,P=0 .005) ,more patients with air-bone gaps <20 dB(Z=3 .05 ,OR=1 .60 ,95% CI(1 .18 ,2 .17) ,P=0 .002) ,but the recurrent rate is not different significantly (test for overall effect :Z= 1 .92 ,OR =1 .87 ,95% CI (0 .99 ,3 .53) ,P=0 .05) .Conclusion The illness is suitable to be treated by using the two surgical ways while the intact canal wall mastoidectomy treatment takes less operative time ,dry ear time and complications ,and improve hearing more significantly than the open mastoidectomy ,but the recurrent rate is not different significantly for trea‐ting cholesteatoma otitis media .
